Hearing the voice of the deinstitutionalized
Adam Vaughan, Simon Fraser University
Symposium on Dispute Resolution, Restorative and Therapeutic Practices,
University of Alaska Fairbanks (March, 2011)
To combat the quarantining of mentally ill persons into mental hospitals in the mid-1970s, health care systems around the world began to shift treatment of the mentally ill from “long-term psychiatric hospitals to more independent living environments” (Krieg, 2001: 367). Lamb and Bachrach (2001) indicate that deinstitutionalization comprises of three procedural processes: the release of mentally ill individuals from psychiatric hospitals to alternative placement in the community, the diversion of new admissions to alternative facilities, and the development of special services for the non-institutionalized mentally ill. During this movement considerable changes were made to mental health legislation (e.g., stricter civil commitment laws), however, these policies have not accommodated the needs of the mentally ill following their release into the community. As a result, other facets of society, such as police officers have absorbed the role of the outpatient mental health system where they work as “street corner psychiatrists” (Teplin & Pruett, 1992).
These interactions are not rare occurrences with some estimates suggesting that 89 percent of police officers encounter an individual suffering from mental illness (LaGrange, 2003), and that 7.2 percent of all calls for police service involve persons with mental illness (Ruiz & Miller, 2004). The amount of mental illness in jails or prisons vary, with some suggesting anywhere between 6-15 percent of persons in jail have a severe mental illness (Cooper et al., 2004).
The deinstitutionalization movement was a human rights violation and a suitable response to such injustices could be through a truth commission. Truth commissions are an effective method for unearthing victimization as they provide a setting for participants to tell their stories, and have them officially documented which can be empowering and therapeutic for participants (Quinn, 2010). The voices of deinstitutionalized patients need to be documented and disseminated to the citizenry. Unfortunately, in the public sphere the mentally ill are often perceived as throwaways operating under a limited degree of rationality. Mental illness is highly stigmatized in society and a truth commission has the potential to promote both individual and societal reconciliation.
Although the deinstitutionalized movement was implemented to counter the effects of hospitalization, the direct impact on the mentally ill is unclear. A country such as Canada is well positioned to conduct this project as it is currently conducting another truth and reconciliation commission detrimental effects of church-run residential schools on Aboriginal peoples. However, any state which has deinstitutionalized the mentally should also consider the utility of the proposed social exercise.
References
Cooper, V. G., McLearen, A. M. & Zapf, P. A. (2004). Dispositional decisions with the mentally ill: Police perceptions and characteristics. Police Quarterly, 7, 295-310
Krieg, R. G. (2001). An interdisciplinary look at the deinstitutionalization of the mentally ill. The Social Science Journal, 38, 367-380.
Lamb, H. R. & Bachrach, L. L. (2001). Some perspectives on deinstitutionalization. Psychiatric Services, 52, 1039-1045.
Quinn, J. R. (2010). The Politics of Acknowledgement: Truth Commissions in Uganda and Haiti. Vancouver, BC: UBC Press.
Ruiz, J. & Miller, C. (2004). An exploratory study of Pennsylvania police officers' perceptions of dangerousness and their ability to manage persons with mental illness. Police Quarterly, 7(3), 359-371.
Teplin, L. A. & Pruett, N. S. (1992). Police as street corner psychiatrists: Managing the mentally ill. International Journal of Law and Psychiatry, 15, 139-156.